What is this test?
This test is used to evaluate cells taken from the inner wall of the uterus (endometrium). This test is used to identify endometrial abnormalities. It is used in suspected cases of endometrial hyperplasia (overgrowth of cells) or endometrial cancer.
Why do I need this test?
Laboratory tests may be done for many reasons. Tests are performed for routine health screenings or if a disease or toxicity is suspected. Lab tests may be used to determine if a medical condition is improving or worsening. Lab tests may also be used to measure the success or failure of a medication or treatment plan. Lab tests may be ordered for professional or legal reasons. The following are possible reasons why this test may be done:
- Uterine lining cancer
- Uterine lining overgrowth
When and how often should I have this test?
When and how often laboratory tests are done may depend on many factors. The timing of laboratory tests may rely on the results or completion of other tests, procedures, or treatments. Lab tests may be performed immediately in an emergency, or tests may be delayed as a condition is treated or monitored. A test may be suggested or become necessary when certain signs or symptoms appear.
Due to changes in the way your body naturally functions through the course of a day, lab tests may need to be performed at a certain time of day. If you have prepared for a test by changing your food or fluid intake, lab tests may be timed in accordance with those changes. Timing of tests may be based on increased and decreased levels of medications, drugs or other substances in the body.
The age or gender of the person being tested may affect when and how often a lab test is required. Chronic or progressive conditions may need ongoing monitoring through the use of lab tests. Conditions that worsen and improve may also need frequent monitoring. Certain tests may be repeated to obtain a series of results, or tests may need to be repeated to confirm or disprove results. Timing and frequency of lab tests may vary if they are performed for professional or legal reasons.
How should I get ready for the test?
Written consent may be required for endometrial sampling. Review the consent form with the healthcare worker and ask any questions that you have before signing the consent form.
Tell your healthcare worker if you have a medical condition or are using a medication or supplement that causes excessive bleeding. If possible, schedule the procedure one week after your menstrual period, because this is when the uterus is least prone to bleeding. Do not douche or have sexual intercourse 24 hours before the procedure.
You may be asked to urinate prior to endometrial sampling. This will make it easier for the healthcare worker to perform the procedure and may make the procedure more comfortable for you.
How is the test done?
For an endometrial sampling, you may be asked to lie on your back with your legs spread and feet placed in stirrups. A speculum will be inserted into your vagina. This tool is used to gently spread apart your vagina. A special tool (endometrial brush biopsy device or endometrial suction catheter) will be inserted into your cervix to reach the interior of the uterus. The tool will be rotated and moved back and forth to collect surface cells from the endometrium. The sample is then sent for testing.
How will the test feel?
The amount of discomfort you feel will depend on many factors, including your sensitivity to pain. Communicate how you are feeling with the person doing the procedure. Inform the person doing the procedure if you feel that you cannot continue with the procedure.
Before collecting a sample of endometrial cells, you may be offered anti-inflammatory medication (NSAID). A regional anesthetic (paracervical nerve block) may be used to help numb the area where the procedure will be done. You may feel mild discomfort, cramping, or pain during and after endometrial sampling.
What should I do after the test?
You may have blood loss from the vagina, but usually for no longer than 24 hours after the procedure. This blood loss should be no more than the amount of blood loss during an average monthly period. Report heavy bleeding to your healthcare worker. It is normal after this procedure to have a gray-green, foul-smelling vaginal discharge for a few days. Contact your healthcare worker if this continues beyond three weeks. After endometrial sampling, avoid vaginal sex, douching, and tampon use for at least one week. Follow the instructions given by your healthcare worker. If a tampon was placed during the procedure, your healthcare worker will tell you when it may be removed. It can usually be removed after 8 to 24 hours.
What are the risks?
Endometrial cells: Endometrial cells are collected by endometrial sampling. This procedure may cause light bleeding from the uterus. If you have a medical condition or use a supplement that causes excessive bleeding, you are at a higher risk of bleeding during or after this procedure. There is a small risk for infection, and very rarely the uterus can be perforated or the cervix can be torn. The person doing this procedure may need to perform it more than once. Talk to your healthcare worker if you have any concerns about the risks of endometrial sampling.
What are normal results for this test?
Laboratory test results may vary depending on your age, gender, health history, the method used for the test, and many other factors. If your results are different from the results suggested below, this may not mean that you have a disease. Contact your healthcare worker if you have any questions. The following is considered to be a normal result for this test:
- Negative cytologic examination
What follow up should I do after this test?
Ask your healthcare worker how you will be informed of the test results. You may be asked to call for results, schedule an appointment to discuss results, or notified of results by mail. Follow up care varies depending on many factors related to your test. Sometimes there is no follow up after you have been notified of test results. At other times follow up may be suggested or necessary. Some examples of follow up care include changes to medication or treatment plans, referral to a specialist, more or less frequent monitoring, and additional tests or procedures. Talk with your healthcare worker about any concerns or questions you have regarding follow up care or instructions.
Where can I get more information?
- American Cancer Society - http://www.cancer.org
- National Cancer Institute - http://www.cancer.gov
 Garcia F, Barker B, Davis J, et al: Thin-layer cytology and histopathology in the evaluation of abnormal uterine bleeding. J Reprod Med 2003; 48:882-888.
 Del Priore G, Williams R, Harbatkin CB, et al: Endometrial brush biopsy for the diagnosis of endometrial cancer. J Reprod Med 2001; 46:439-443.
 Byrne AJ: Endocyte endometrial smears in the cytodiagnosis of endometrial carcinoma. Acta Cytol 1990; 34:373-381.